Ventricular tachycardia electrical cardioversion: Difference between revisions
(/* Recommendations for Patients With Implantable Cardioverter-Defibrillators (DO NOT EDIT){{cite journal |author=Stevenson WG, Soejima K |title=Catheter ablation for ventricular tachycardia |journal=Circulation |volume=115 |issue=21 |pages=2750–...) |
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Patients with implanted | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Patients with implanted [[ICD]]s should receive regular follow-up and analysis of the device status. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' Implanted | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' Implanted [[ICD]]s should be programmed to obtain optimal sensitivity and specificity. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' Measures should be undertaken to minimize the risk of inappropriate ICD therapies. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' Measures should be undertaken to minimize the risk of inappropriate [[ICD]] therapies. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Catheter ablation can be useful for patients with implanted ICDs who experience incessant or frequently recurring VT. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[Catheter ablation]] can be useful for patients with implanted ICDs who experience incessant or frequently recurring VT. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' In patients experiencing inappropriate ICD therapy, EP evaluation can be useful for diagnostic and therapeutic purposes. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' In patients experiencing inappropriate [[ICD]] therapy, EP evaluation can be useful for diagnostic and therapeutic purposes. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
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Revision as of 19:40, 15 January 2013
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Ventricular tachycardia Microchapters |
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Differentiating Ventricular Tachycardia from other Disorders |
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Diagnosis |
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Treatment |
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Ventricular tachycardia electrical cardioversion On the Web |
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Ventricular tachycardia electrical cardioversion in the news |
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to Hospitals Treating Ventricular tachycardia electrical cardioversion |
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Risk calculators and risk factors for Ventricular tachycardia electrical cardioversion |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in Chief: Avirup Guha, M.B.B.S.[2]
Overview
Therapy may be directed at either terminating an episode of the arrhythmia or for suppressing a future episode from occurring. The treatment is tailored to the specific patient, with regard to how well the individual tolerates episodes of ventricular tachycardia, how frequently episodes occur, their comorbidities, and their wishes. It is usually possible to terminate a VT episode with a direct current shock across the heart. This is ideally synchronised to the patient's heartbeat. As it is quite uncomfortable, shocks should be delivered only to an unconscious or sedated patient.
Electrical Cardioversion
It is usually possible to terminate a VT episode with a direct current shock across the heart. This is ideally synchronised to the patient's heartbeat. As it is quite uncomfortable, shocks should be delivered only to an unconscious or sedated patient. A patient with pulseless VT will be unconscious and treated as an emergency on a cardiac arrest protocol. Elective cardioversion is usually performed in controlled circumstances with anaesthetic and airway support.
The shock may be delivered to the outside of the chest using an external defibrillator, or internally to the heart by an implantable cardioverter-defibrillator (ICD) if one has previously been inserted.
An ICD may also be set to attempt to overdrive pace the ventricle. Pacing the ventricle at a rate faster than the underlying tachycardia can sometimes be effective in terminating the rhythm. If this fails after a short trial, the ICD will usually stop pacing, charge up and deliver a defibrillation grade shock.
2011 ESC Guidelines for Electrical Cardioversion in Ventricular Tachycardia (DO NOT EDIT)[1] [2]
Recommendations for Patients With Implantable Cardioverter-Defibrillators (DO NOT EDIT)[1][2]
| Class I |
| "1. Patients with implanted ICDs should receive regular follow-up and analysis of the device status. (Level of Evidence: C)" |
| "2. Implanted ICDs should be programmed to obtain optimal sensitivity and specificity. (Level of Evidence: C)" |
| "3. Measures should be undertaken to minimize the risk of inappropriate ICD therapies. (Level of Evidence: C)" |
| "4. Patients with implanted ICDs who present with incessant VT should be hospitalized for management. (Level of Evidence: C)" |
| Class IIa |
| "1. Catheter ablation can be useful for patients with implanted ICDs who experience incessant or frequently recurring VT. (Level of Evidence: B)" |
| "2. In patients experiencing inappropriate ICD therapy, EP evaluation can be useful for diagnostic and therapeutic purposes. (Level of Evidence: C)" |
References
- ↑ 1.0 1.1 Stevenson WG, Soejima K (2007). "Catheter ablation for ventricular tachycardia". Circulation. 115 (21): 2750–60. doi:10.1161/CIRCULATIONAHA.106.655720. PMID 17533195. Retrieved 2013-01-15. Unknown parameter
|month=ignored (help) - ↑ 2.0 2.1 "The AHA Guidelines and Scientific Statements Handbook - Google Books". Retrieved 2013-01-15.